To describe the feasibility and perioperative outcome of suprarenal resection of inferior vena cava (IVC) in urologic neoplasms without reconstruction.
We retrospectively reviewed the patients who underwent suprarenal resection of IVC without reconstruction for urologic neoplasms in our institution between September 2010 and October 2019. Patients’ demographic, clinical, radiologic, and 90-day perioperative complications were recorded.
Twenty-eight (79% male) patients with a median age of 59 (25-75) years were included in the study. Twenty-five (89%) of patients had renal cell carcinoma, one had renal leiomyosarcoma, and two had metastatic testicular teratoma. Twenty-two patients had Mayo level 3 thrombus, three had level 2 and three had level 4. The mean radiologic thrombus length was 12.6 cm. Eleven patients had radiologic bland thrombosis in the infrarenal IVC. Twenty-seven patients underwent open, and one robotic surgery. The median operating time was 411 (range 240-808) minutes, median blood loss was 3750 cc, and all but one patient received perioperative transfusion (median 11 units of packed red blood cells). Median hospital stay was 5 (3-50) days. 90-day complication rate was 35% (Clavien-Dindo grade I/II and III/IV were 21% and 14%, respectively). Four patients (14%) developed transient non-disabling leg edema. The 90-day mortality rate was 7%.
Suprarenal inferior vena cava resection without reconstruction is feasible, yet high-risk operation that should be performed in experienced centers in selected patients with urologic malignancies.

Copyright © 2020. Published by Elsevier Inc.